Progressive Quadriparesis of a Toddler with a Posterior Cranial Fossa Arachnoid Cyst (AC): Illustrative Case Report and Narrative Literature Review.

Background/objectives: Intracranial arachnoid cysts (ACs) may be congenital, primary, or secondary due to trauma. These cysts are benign, contain cerebrospinal fluid (CSF), and are classified based on location, size, and their clinical symptomatology. They are uncommon lesions in children, rarely leading to severe mass-effect neurological symptomatology.

Distal Biliary Stent Migration in Patients with Irretrievable Bile Duct Stones: Long-Term Comparison Between Straight and Double-Pigtail Stents.

Background: Prolonged biliary stenting may be considered in high-risk patients with irretrievable bile duct stones (IBDS). Distal stent migration (DSM) is a known complication, although data beyond the recommended interval of temporary stenting (3-6 months) are lacking. We compared the long-term incidence of DSM between straight and double-pigtail stents in patients with IBDS.

Cold snare polypectomy vs. hot snare polypectomy vs. argon plasma coagulation for small (5-9mm) left-sided colorectal polyps: a prospective randomized trial.

Objective: To compare recurrence rates among three endoscopic treatment modalities for 5-9 mm left-sided colorectal polyps.

Methods: Consecutive adults referred for elective colonoscopy (1/2015-1/2018) with at least one polyp of eligible size (5-9 mm) located distally to the splenic flexure were randomly assigned (1:1:1) to one of three treatment modalities: (1) cold snare polypectomy (CSP), (2) hot snare polypectomy (HSP) and (3) argon plasma coagulation (APC) ablation (50-60 W, flow: 2 l/min). The polyp site was marked with an endoscopic tattoo, and a follow-up colonoscopy with scar biopsies was performed >6 months after the index procedure.

An update on current and advancing pharmacotherapy options for the treatment of H. pylori infection.

: Eradication of becomes more challenging due to increasing antimicrobial resistance. Consequently, the performance of clarithromycin-containing triple therapies is now declining to unacceptable levels and should be abandoned unless a prior susceptibility test precludes clarithromycin resistance.: This review summarizes updated evidence concerning new and advancing pharmacotherapy options for eradication.

Simulated performance of flexible sigmoidoscopy-based screening for advanced neoplasia detection in a Greek population.

Background: Flexible sigmoidoscopy (FS) is resource-conserving and may increase adherence to colorectal cancer (CRC) screening compared to total colonoscopy. We investigated the diagnostic performance of FS-based screening for advanced colorectal neoplasia (ACN), including advanced adenomatous neoplasms (AANs), advanced serrated lesions (ASLs) and CRCs.

Methods: Data from 2005 subjects undergoing average-risk screening colonoscopy in a single center in Greece were retrospectively reviewed.

Persistence and adherence to nucleos(t)ide analogues in chronic hepatitis B: a multicenter cohort study.

Background: Adherence and persistence to long-term therapy with nucleos(t)ides analogues are crucial to the outcome of treatment in chronic hepatitis B. Our aim was to determine the persistence and adherence rates to nucleos(t)ides analogues in chronic hepatitis B patients under maintenance therapy and to identify relative to prediction of adherence factors.

Methods: We retrospectively analyzed electronic prescription data of patients (2011-2016; n = 400) with chronic hepatitis B treated with nucleos(t)ides analogues at 4 tertiary liver centers in Greece.

Comparison of digital versus fiberoptic cholangioscopy in patients requiring evaluation of bile duct disease or treatment of biliary stones.

Background: Recently, the introduction of the novel digital SpyGlass™ DS Direct Visualization system (Boston Scientific Corp., Natick, MA, USA) has signaled the transition into the era of digital single-operator cholangioscopy (D-SOC). We sought to compare the clinical utility between fiberoptic single-operator cholangioscopy (F-SOC) and D-SOC in a tertiary-care referral center in Greece.

Hybrid therapy as first-line regimen for eradication in a high clarithromycin resistance area: a prospective open-label trial.

Background: Hybrid therapy is a promising first-line regimen for () eradication. We evaluated a hybrid therapy, assessing the impact of antibiotic resistance on eradication outcome.

Methods: This was a prospective study that included 155 treatment-naïve patients diagnosed with infection by positive CLO-test, confirmed with histology and/or culture.

Seven-day genotypic resistance-guided triple eradication therapy can be highly effective.

Background: The efficacy and applicability of molecular testing to guide the selection of antibiotics in triple ( eradication regimens have not been reported. We tested a 7-day, genotypic resistance-guided triple eradication therapy in a high-resistance setting.

Methods: Consecutive dyspeptic patients with infection were prospectively enrolled.

Cold versus hot endoscopic mucosal resection for nonpedunculated colorectal polyps sized 6-10 mm: a randomized trial.

Background And Study Aims: Cold snare polypectomy is an established method for the resection of small colorectal polyps; however, significant incomplete resection rates still leave room for improvement. We aimed to assess the efficacy of cold snare endoscopic mucosal resection (CS-EMR), compared with hot snare endoscopic mucosal resection (HS-EMR), for nonpedunculated polyps sized 6 - 10 mm.

Patients And Methods: This study was a dual-center, randomized, noninferiority trial.

Long-term recurrence of bile duct stones after endoscopic papillary large balloon dilation with sphincterotomy: 4-year extended follow-up of a randomized trial.

Background: Endoscopic papillary large balloon dilation with biliary sphincterotomy (EPLBD + EBS) is safe and effective in patients with large common bile duct (CBD) stones. However, data on long-term outcomes after EPLBD + EBS remain limited. We sought to prospectively evaluate the long-term recurrence of CBD stones after EPLBD + EBS and to identify the associated factors.

A delayed onset of bowel activity after the start of conventional polyethylene glycol predicts inadequate colon cleansing before colonoscopy: A prospective observational study.

Background: Evaluation of factors correlating with the quality of bowel preparation (QBP) is critical to ensure high-quality colonoscopy.

Objectives: We sought to determine whether the time interval between the start of conventional polyethylene glycol (PEG) ingestion and the onset of bowel activity is predictive of QBP.

Methods: Consecutive adult outpatients attending colonoscopy were prospectively assessed.

Helicobacter pylori and colorectal neoplasia: Is there a causal link?

Ever since Helicobacter pylori (H. pylori) was recognized as an infectious cause of gastric cancer, there has been increasing interest in examining its potential role in colorectal carcinogenesis. Data from case-control and cross-sectional studies, mostly relying on hospital-based samples, and several meta-analyses have shown a positive statistical relationship between H.

Treatment of Helicobacter Pylori infection: optimization strategies in a high resistance era.

Introduction: Treatment of Helicobacter pylori (H. pylori) infection is paramount for the management of prevalent gastrointestinal disorders and in the prevention of gastric cancer. Due to increasing antimicrobial resistance, performance of standard triple therapies has now declined to unacceptably low levels.

Current status and emerging challenges in the treatment of hepatitis C virus genotypes 4 to 6.

Hepatitis C virus (HCV) genotypes 4, 5 and 6 are mainly present in Africa, the Middle East and Asia and they have been less extensively studied with respect to epidemiology, natural disease history and therapeutic endpoints. Response rates to a 48-wk combined peginterferon/ribavirin treatment range to 40%-69% for HCV 4, 55%-60% for HCV 5 and 60%-90% for HCV 6. Response-guided schedules are recommended to optimize the outcomes of peginterferon/ribavirin treatment in HCV 4 and, in form of preliminary data, for HCV 6, but no data are yet available to support such an individualization of therapy for HCV 5.

Treatment of Helicobacter pylori infection: Past, present and future.

Helicobacter pylori (H. pylori) is a major human pathogen associated with significant morbidity and mortality. However, after decades of efforts, treatment of H.

Treatment of Helicobacter pylori infection: meeting the challenge of antimicrobial resistance.

Treatment of Helicobacter pylori (H. pylori) infection is paramount for the management of prevalent gastrointestinal disorders including peptic ulcer disease and gastric cancer. Due to the wide increase in prevalence of H.

Current and future insights in H. pylori eradication regimens: the need of tailoring therapy.

Treatment of Helicobacter pylori (H. pylori) infection is crucial for the management of prevalent digestive and more recently also extra-digestive disorders. Rising prevalence of clarithromycin resistance worldwide has accounted for a dramatic decline in the efficacy of standard triple therapies, which should not be prescribed, unless local clarithromycin-resistance is low (<20%) or culture confirms susceptibility to this antibiotic (i,e,; as tailored treatments).

Hepatitis C virus genotype 5: prospective evaluation of peginterferon/ribavirin treatment efficacy and predictive value of on-treatment virological responses for sustained virological response.

Goals: To examine the treatment efficacy of a combination of pegylated interferon α (PegIFNa) plus ribavirin in patients chronically infected with hepatitis C virus genotype 5 (HCV-5) and to assess the on-treatment virological responses as predictors of sustained virological response (SVR).

Background: HCV-5 is uncommonly reported, and little therapeutic data is available regarding previous retrospective studies yielding contradictory results.

Study: In a prospective, open-label, single-center study, 27 treatment-naive HCV-5 patients, treated for 48 weeks with PegIFNa-2a/ribavirin, were evaluated.

Durability of a sustained virological response, late clinical sequelae, and long-term changes in aspartate aminotransferase to the platelet ratio index after successful treatment with peginterferon/ribavirin for chronic hepatitis C: a prospective study.

Objectives: Previous studies, mostly retrospective using conventional interferon, have suggested a favorable prognosis for patients with chronic hepatitis C and a sustained virological response (SVR). However, long-term outcome, including changes in the degree of hepatic fibrosis, of SVR patients in the era of pegylated interferon (PegIFN) remains underdefined. We prospectively evaluated the long-term virological, clinical, and biochemical outcomes, including aspartate aminotransferase-to-platelet ratio index (APRI), in chronic hepatitis C patients with an SVR.